How Vetter Senior Living cut time to accept in half with exacare ai

Introduction

“exacare ai not only improves our efficiency, but our accuracy and ability to get things correct, because we're not spread so thin as a team.”

Vetter Senior Living is a non-profit provider of skilled nursing, independent living, assisted living, rehabilitation, home health, and hospice care. The organization has grown to 35 communities across Nebraska, Wyoming, and Missouri.

Before exacare ai, reviewing referrals at Vetter was a process that required bringing several people together: a director of nursing to weigh clinical fit, a social services director to review psychosocial and financial details, and often even an office manager for a deeper financial look. Teams were experienced and committed to a high standard of care, but a high volume of referrals meant valuable time taken away from already overextended clinicians, making the manual process difficult to sustain.

Since implementing exacare ai, Vetter has been able to hand off the first pass of that review. Clinical details, medications, equipment needs, and potential concerns that were once deeply buried in documents have become immediately accessible, giving Vetter’s teams a clearer starting point for deciding on which referrals need a closer look.

Key Results

• Moved-in admissions up 95% comparing Vetter’s first quarter on exacare ai with Q4 2025
• 50% reduction in time to accept from Vetter’s first months on the platform
• Conversion rate saw a 32% relative improvement, even as referral volume grew 48%
• Better coordination across facilities, so teams no longer duplicate work reviewing the same referral a nearby building has already accepted
• Time back to the team: one Omaha office absorbed a staff departure without immediately backfilling the role and still hit its highest census in years

The Customer

Vetter Senior Living is a full continuum of care provider that has served residents across Nebraska, Missouri, and Wyoming since 1975. Roughly 4,000 team members carry out the organization’s mission of “Dignity in Life”, balancing speed of admissions with the quality residents and families deserve.

Serving in both urban and rural markets means Vetter’s admissions teams face two very different operating realities at once. In the Omaha-Lincoln metropolitan area, facilities may have dedicated admissions staff handling a large influx of referrals. In rural Nebraska, the same volume of decisions can fall to a much leaner team, with individuals having to wear multiple hats to get a referral through the door.

Vetter uses exacare ai to consolidate a decision making process that was once spread across many parties. Instead of physically gathering everyone to review referrals, staff can review clinical and financial details directly in the platform and coordinate through it.

Customer Snapshot

• Customer Since: January 2025
• Size: 32 facilities
• Region: Nebraska, Missouri, and Wyoming
• Industry: Senior living and full continuum of care (Independent living, assisted living, skilled nursing, rehabilitation, home health and hospice)
• Products: Admissions screening, data center, reporting, and bed board

The Stakeholders

Mark Iverson, Chief Operations Officer

Mark Iverson oversees long-term care, skilled nursing, home health, hospice, therapy, pharmacy, assisted living, and independent living operations across Vetter. He joined Vetter in 2024 and moved through Director of Leadership Development and Senior Director of Operations before stepping into his current role. Before Vetter, Mark led operations in the senior living and care space for nearly 20 years and he spent over a decade on the Nebraska Health Care Association's board, including two years as Co-Chair.

Tami Thiesen, Senior Director of Operations

Tami Thiesen oversees Vetter's skilled nursing, assisted living, independent living, and therapy operations. Before her role in operations leadership, she served as Senior Director of Therapy Operations, following a career that began as a physical therapist assistant in home health. Her background gives her a deep understanding of the clinical and operational realities teams face across Vetter's care settings.

Chay Indra, Senior Director of Clinical Operations

Chay Indra is a registered nurse who has spent more than a decade with Vetter, first joining as a Clinical Coordinator. She now oversees nursing across Vetter's assisted living and skilled nursing communities. Before Vetter, she led nursing as Director of Nursing at a 70-bed skilled nursing facility. She was part of the original team that evaluated exacare ai and helped bring it into Vetter's admissions workflow.

Sasauna Alberts, Director of Social Work and Admissions

Sasauna Alberts supports and consults with Vetter’s facilities across western Nebraska and into Wyoming. She previously served as a Social Services Coordinator at Brookestone Gardens, one of Vetter’s facilities, where she received the AseraCare Heart of Hospice award for her advocacy on behalf of residents.

Corie Sass, Director of Social Work and Admissions

Corie Sass is a licensed clinical social worker, licensed mental health practitioner, and certified dementia practitioner supporting facilities on the east side of Nebraska and in Springfield, Missouri. She holds 20+ years of experience in senior care, including 18 with Vetter Senior Living. She received the Advocate Award at exacare ai’s inaugural awards ceremony, recognizing her work of championing the platform with hospital partners. Read more about her recognition here.

The Challenge: Rising Referral Volume Outpacing a Manual Process

In Vetter's rural communities, reviewing a referral fell to the same small group of leaders who wore several other hats across the building. Speed mattered, for winning the referral and for keeping hospitals coming back, and holding onto that speed got harder as referral volume climbed.

“Nurse leadership is already juggling about fifteen other responsibilities. Finding time to review a referral just isn't easy to fit in.”

The packets themselves added to this load, often arriving by fax as lengthy stacks of clinical documentation.

“When you’re looking at 80+ pages of documentation, you’re bound to miss something”

Even with a thorough review, speed wasn't guaranteed. A packet could sit with a nurse leader overnight before Vetter got back to the hospital, and every hour counted.

“We were losing admissions to other locations that responded faster, or saying no to a referral because we didn't have a clear enough understanding of the diagnosis.”

This growing volume of referrals also meant duplicated effort across the organization. In markets like Omaha, multiple buildings were sometimes reviewing the same exact referral without knowing it, each one working through the packet independently.

“That's when we started asking ourselves: what could we do differently? What if there was a system that could take some of that workload off our plates and make it more manageable?”

These questions became urgent as Vetter’s home office began to compare referral volume to occupancy.

“Why would we have 25 open beds if there are 500 referrals coming in? We want to take care of as many people as we can across Nebraska, Wyoming, and Missouri.”

What Vetter needed was a way to move through referrals faster without losing the clinical judgement that had always guided its decisions.

The Solution: A Faster, Consolidated Admissions Workflow

Vetter began searching for a solution that would reduce the operational burden of the referral review process, so that staff could spend less time filtering through paperwork and more time with patients.

“Being able to scan through a referral quickly and manage it better was really what pushed us to look into exacare ai.”

exacare ai's ability to read each referral packet in full and recommend an accept or decline based on rules built around each facility's own criteria made it the right fit for Vetter. Routine steps like sex offender registry checks would also be automated, so packets would only get pulled into leadership’s day if they truly require a closer look.

The Implementation

Vetter started on exacare ai with four facilities and ten team members, moving from discovering the platform to full go-live in about three months and connecting facilities within the first two. Across the six connected facilities, exacare ai has screened more than 51,000 referrals since January 2025.

The onboarding process was thorough and collaborative, with weekly check-ins between the Vetter and the exacare ai team. When concerns came up, they didn’t sit unresolved.

“Anytime our team brought something to the exacare ai team, it wasn't like, ‘Oh, we'll think about that.’ They literally had a solution within a couple of days or a week.”

This responsiveness carried through the rest of onboarding. Each Vetter facility configured exacare ai’s admissions criteria rules to reflect what actually mattered for their building, rather than working within a one-size-fits-all system, and that same collaborative approach shaped the close relationship Vetter built with the exacare ai team.

“The nice thing is, those relationships have continued and grown, even as new people have joined the exacare ai team.”

The Impact

Time to accept dropped by roughly 50%

Before exacare ai, the process of reviewing referrals could take several hours, pulling together multiple parties to reach a decision. This was especially difficult for nursing staff, who had to balance that time against their responsibilities to current residents.

Today, the first pass of that review moves much faster. exacare ai reads each packet against the facility’s custom rules and generates a recommendation, and when a referral doesn’t clearly meet the criteria, staff can see exactly why it was flagged and access the context they need to decide quickly.

Compared with its initial response times at implementation, Vetter’s time to accept has dropped by roughly 50%

“There's still a fair number of referrals that land in that in-between zone, but now we know why. We can spot the medications and catch the details that used to get buried. That gets us to a yes faster, with a clearer sense of what we'll actually need to take care of that resident.”

Fewer surprises on medications

By surfacing details that used to get lost in lengthy packets, exacare ai provides Vetter’s clinical team with greater visibility into hidden medication needs and costs.

“Sometimes there's something a little more hidden, not on the active medication list, like a chemo drug or something that's only given once a month. Those are the kinds of things that are easy to miss.”

Catching those details earlier has also mattered for Vetter's bottom line.

“Just knowing that it's catching those things that could lead to some pretty significant write-offs, exacare ai has definitely helped.”

Moved-in-admissions grew by 95%

Referral volume across Vetter’s connected facilities grew 48% and moved-in admissions grew 95%. The conversion rate, measured as moved-ins divided by total referrals, rose from 3.1% to 4.1%, a relative improvement of roughly 32%.

Vetter’s leadership team connected the organization’s occupancy and census gains directly to its most recent financial results, describing exacare ai as one of the drivers behind the strongest fiscal year the organization has seen since before the pandemic.

“We’re taking care of more residents across the board than we likely ever have, certainly since pre-COVID days.”

Clearer visibility into referral volume

Before exacare ai, the home office had little line of sight into what was happening with referrals at the facility level. Volume, declines, and the reasons behind them lived inside each building. Now, leadership can see every referral and every accept or decline decision across the organization, which has changed the questions they ask when beds sit open.

“When a building has 10 open beds and we’re asking why, we can go into exacare ai, pull up a green referral they didn’t accept, and ask the team to walk us through that decision.”

That visibility has turned census conversations from anecdotes into evidence. Chay points to Medicare Advantage as the clearest example. Managed care is a real pressure on skilled nursing census, and it's often the first explanation a building reaches for when occupancy dips. The data doesn't always agree.

“The communities will say the Medicare Advantage plans are wanting to discharge. But then we can pull a report that says, well, we denied nine green straight-Medicare payers. Being able to pull that information and look at it together helps the building see where their opportunities are.”

Sustaining census through staffing gaps

When staffing gaps came up through attrition, exacare ai’s impact showed up clearly, as the platform helped Vetter’s teams bridge this difference while hiring for the role. In a high-volume Omaha community, leadership committed to backfilling the position and, in the meantime, worked with existing staff to make full use of exacare ai.

Both communities went on to reach their highest census in a long time, even while short a team member.

What’s Next

Vetter plans to expand exacare ai to three more facilities. The organization’s home health line in Omaha already uses the platform, and Vetter is hiring a home-office nurse to quarterback admissions across the field. The role exists because exacare ai gave the home office visibility it never had, and the job will be to coach teams, confirm clinical fit, and help each resident reach the right level of care.

As Vetter continues to grow with exacare ai, the goal remains the same: giving nurses, admissions coordinators, and home-office leaders more time and more confidence, so that every referral gets the attention it deserves, and every resident who belongs at a Vetter community finds their way there.