David Gehm says nonprofits need to hold "high moral ground."

Nonprofit long-term care providers must work together to address alarming trends, or their market share could plummet, LeadingAge Chairman David Gehm told association members.

While he is “optimistic” after his first year leading the Board, he has identified trends that “might give us pause,” Gehm said at the General Session of the association’s recent annual conference in Nashville. 

The for-profit LTC sector is growing nearly eight times as fast as the nonprofit sector, Gehm warned, citing figures from investment bank Ziegler. In particular, nonprofit providers are shedding skilled beds. Projections indicate this “core service” of nonprofits will continue to shrink, he said, and for-profit providers might be “buying our beds almost as fast as we put them on the market.” Additionally, many nonprofits are struggling to access affordable capital, while for-profits are “leveraging and building housing and assisted living all around us,” he declared.

Many nonprofits also are having trouble attracting top-flight workers, and there is a need for action, he said. To this end, LeadingAge has “elevated the health of our members as a major strategic objective,” he announced.

A vibrant nonprofit long-term care sector benefits the whole country, Gehm emphasized. These providers occupy “high moral ground that no one else can hold,” he said. The future will be bleak if they lose market share and influence, because they inform public policy and help ensure that the long-term care system as a whole is mission-driven.

Conference attendees also weighed in on challenges, with a few noting that skilled beds increasingly are difficult to fill. An employee of a continuing care retirement community said she and her colleagues discussed making assisted living the “end of the continuum” at their location. Others floated offering niche services for things such as ALS, cancer or COPD patients.