Staffing issues continue to drive reduced admissions in SNFs

Nursing home providers continue to struggle with staffing challenges as they aim to reboot admissions in the post-pandemic era, according to the newly released results of a recent Ziegler CFO Hotline survey.

“The demand for our SNF services is rising at a rate significantly higher than our labor force allows,” said one respondent.

The poll solicited responses from more than 240 chief financial officers and finance professionals about changes in occupancy within the past two years. Approximately 60% of respondents worked at single-site senior living providers, with the remaining 40% representing multi-site providers. According to Zielger, the respondent pool was heavily weighted towards not-for-profit continuing care retirement / life plan communities, but only those that have a skilled nursing component.

“We budget a loss on skilled nursing, and if it were not for our other lines of business, we couldn’t sustain it,” one respondent said. “As a nonprofit continuing care facility, we want and need to keep skilled care part of our continuum, but the long-term sustainability is concerning.”

On average, according to the responses, nursing care beds make up 27% of total units offered in CCRCs. Seventy-one percent of those skilled nursing beds are in single-occupancy rooms.

Forty-six percent of the respondents to the November survey indicated that staffing issues have forced a reduction in SNF admissions. Forty-three percent said the decline in admissions was caused by other factors, such as reimbursement challenges, the regulatory environment and inflation; 11% said they have experienced no reduction in staff.

“New state and federal staffing regulations [are] causing us to think whether SNF is needed,” said one respondent.

More than a third of providers responding indicated that they had made permanent reductions in the number of beds over the past two years.

“While most providers who reduced their number of SN beds did so by fewer than half, a smaller number reduced their beds by 51- % to 99%, and a few providers reported they had exited the skilled nursing industry entirely,” Ziegler Senior Living Research Assistant Lily Ludwig said. “Of those, two closed their skilled nursing facility, another two repositioned their skilled nursing units to assisted living units, and one sold to a for-profit.”