How senior living can avoid skilled care's nightmare

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John O'Connor
John O'Connor

Even casual observers know these are tough times for the skilled care field.

Two just-out reports provide both details and context. First there was an update from Irving Levin Associates finding that the average price per-bed for skilled nursing facilities plunged 18% in 2017.

Not to be outdone, Avalere released its own investigation that shows Medicare beneficiaries have been dialing back their days in skilled nursing facilities since 2009.

So what? Skilled care is a different business, right? Well, perhaps in some ways.

But any senior living operator who doesn't consider the why behind the ongoing skilled care downturn might soon face similar headwinds.

Distilled down, skilled care now finds itself coming up short for two reasons: cost and fit.

Simply put, nursing homes are being seen by many hospitals as less affordable than other discharge options, particularly home care. And if there is one thing we've learned about post-acute discharges in recent decades, it's that cheaper usually gets the girl (and the occasional guy).

Which brings us to the second issue. How does a hospital know you are going to be a good fit (as in, pose a lower readmission risk)? You'll need to document your competence with data. You'll need data that show you are bit better than other nearby settings when it comes to preventing hospital bounce backs. Moreover, you'll need data to show that in addition to preventing readmissions, your patients / residents tend to heal faster and stay healthier.

Admittedly, being less expensive while offering more expansive data is no small feat. Some might even say it's an either/or proposition. But being able to do both is the challenge you now face, or soon will.

Nursing homes are the proverbial canary in the coal mine. And man, are they chirping away. The real question is this: Are you listening?

John O'Connor is editorial director of McKnight's Senior Living. Email him at john.oconnor@mcknights.com.

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