John O'Connor

If you have spent any time on Capitol Hill, you probably noticed a major divide between the Senate and House chambers. And it has nothing to do with the District of Columbia’s geography.

This separation is strictly a matter of attitude. To put it politely, many of the folks who toil for Senators tend to see their House counterparts as being not quite equal.

Maybe it has to do with the Senate’s reputation for being a more deliberative body. Or perhaps it’s just that there are four fewer years between House elections. Regardless, the snobbery is palpable.

What does this have to do with skilled care? Well, it turns out quite a few skilled care operators tend to look at assisted living in much the same way. Yes, both sectors may be in the business of taking care of old people who need assistance. But many on the skilled side tend to see themselves as being a bit, ahem, more qualified. 

After all, skilled care is federally regulated and requires licensed personnel, right? It partners with hospitals and sees its real customer as mostly being the government, correct?

To be sure, those are hardly irrelevant distinctions. But they were far more germane a decade ago. For in case you haven’t noticed, assisted living has been changing. A lot.

Assisted living communities are serving more customers with conditions that until recently would have landed them in skilled settings. And I’m not talking about just dementia cases.

As a skilled care professional, you may have concluded that assisted living communities serve a different role. But do they, really? What can be said with certainty is that more of them are interested in housing your residents.

But don’t take my word for it. Take Larry Cohen’s. He is the CEO of Dallas-based Capital Senior Living. And what did Mr. Cohen tell analysts at an earnings call last week? That his organization wants to increase partnerships with health systems and play a larger role in the post-acute care continuum.

Does this sound like someone who sees himself in a different line of work?

And he’s hardly alone. You can bet that there are plenty of other assisted living communities that would absolutely love to be on the receiving end of hospital transfers.

For now, skilled care has a bit of a data advantage. Particularly when it comes to care outcomes. But that gap is going to narrow in the years to come. Then what?

There are numerous strategic moves skilled care operators might want to contemplate. But living in denial is not one I’d recommend.