The most dangerous time of the year has arrived.

Many readers are in recovery mode right now. Those holiday sugar plums delivered serious body blows. So did the extended conversations with relatives. Throw in the irregular work hours, lounging around and travel time — and many of us are a bit out of sync.

And now it’s go time? Where to start?

If it helps ease the transition, here are 10 predictions about the road ahead in 2020:

Prediction 1:  PDPM will play out in ways both obvious and unexpected.  We’ve already seen some of the early moves: therapist layoffs and new approaches to care. The Centers for Medicare & Medicaid Services will surely take stock and tweak both the rules and payment rates.

Prediction 2: Arbitration wars will kick into high gear. Providers love arbitration agreements. AARP hates them. Need more be said?

Prediction 3: It’s going to be a tale of two markets for nursing homes. Urban settings will start to see a bit of an influx, thanks in part to the Silver Tsunami. Rural facilities will struggle. Among the latter, the number of closings in 2020 might be shocking.

Prediction 4: Tech will get bigger. Skilled care is doing more than shifting from high-touch to high-tech. It is embracing tech tools in every conceivable new way. That trend won’t just continue; it will intensify.

Prediction 5: Healthcare will be a major election year topic; long-term care not so much. Sure, there will be the usual lip service about making things better. But when all is said and not much is done, the insurance companies, healthcare systems, docs and other players with real clout will eat first.

Prediction 6: This will be the ugliest election year ever. Why? For starters, we have a president seeking re-election that 40% of the country loves and 40% can’t stand. The battle to win over enough of the rest will be brutish, nasty and long. Fear is what sells, so you can probably imagine what the messaging will look like. Then again, maybe you can’t?

Prediction 7: The infamous “Do Not Proceed” logo will not be going anywhere. Everyone knows what an open palm stop sign means. Everyone that is, except CMS. They have heard your concerns about the heavy-handed moniker. But rather than adjust, they have opted instead to go the Mike Mulvaney route. In other words, providers can just deal with it.

Prediction 8: Staffing demands will stiffen. Never mind that finding and keeping workers is arguably the biggest challenge the industry faces. It’s election season. That means candidates at every point will be demanding staffing quotas.

Prediction 9: More big fish will be going to the big house. Yes, this is an industry primarily run by people trying to make a good difference. The problem for some is the temptation to grab easy money by cheating ever so slightly. Most who give in won’t get caught. But a few will. It happens every year.

Prediction 10: Something we’re not noticing now will play a big role. Fast forward to December, and we’ll be amazed that an issue that is so blatantly obvious remained under the radar.

There you have it: 10 fearless predictions about the year that will be. Feel free to thank (or ridicule) me later.

John O’Connor is editorial director for McKnight’s.