Study confirms what many suspect: Assisted living's growth taking a toll on skilled care private pay

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David Grabowski, Ph.D.
David Grabowski, Ph.D.

Many operators are convinced senior living is growing at skilled care's expense. A new study adds nuance to the numbers.

“Our research suggests private pay occupancy has fallen in nursing homes located in counties with disproportionately high growth in assisted living," co-author David C. Grabowski, Ph.D., a professor of healthcare policy at Harvard Medical School, told McKnight's Senior Living.

Investigators examined the respective sectors at the county level between 2007 and 2014. During that time, the mean number of assisted living beds rose by more than 13%. Over the same span, there was a measurable reduction in the amount of time that skilled care residents paid privately for their care.

The authors cited several possible explanations for the private-pay downturn in skilled care settings. One is that assisted living residents are staying put longer, even as their conditions worsen. Another is that people recovering from an acute event are transitioning to assisted living settings at the conclusion of their rehab care, as opposed to remaining in skilled care buildings.

The authors add that as these trends continue, it will be important to monitor spillover effects as they relate to issues such as the operational structure of skilled care facilities, care processes and care outcomes.

Full findings appear in Health Services Research.

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