Of all the sayings attributed to Abraham Lincoln, the one I probably like the most has to do with attitude.

“Folks are usually about as happy as they make their minds up to be,” the lanky railsplitter is quoted as saying. It stands true for just about any facet of life.

But as long-term care heads into 2023 — battered but not broken — it’s more apropos than ever.

Its leaders and key players have a long history of looking at conditions skeptically. Government-constrained pay, long hours, a thicket of regulations both federal and local. Add in clientele who, by the laws of nature, will typically decline, not get better, unless they’re in for short-term rehab.

There are a lot of understandable reasons to put on a Debbie Downer or Johnny Raincloud mask. Eeyore has nothing on many nursing home employees (and, in all candor, many journalists).

So that’s what may make this next statement a bit tough to swallow. The year 2023 could — just might — bring reasons for Optimism. No doubt the big O is foreign to many reading this, but it doesn’t have to be that way. It’s there, if you know where to look for it.

This week, for example, we’ve featured results of our McKnight’s 2023 Outlook Survey, the most expansive of any in the sector. Senior Editor Kimberly Marselas has unfolded the implications of the responses of nearly 1,000 administrators, directors of nursing, owners and other C-suiters who took part in the survey.

It’s important to note that one of the first findings highlighted was the decline in pessimism. Those who were optimistic grew by more than half since this time last year. Meanwhile, those more pessimistic dropped by an even greater percentage. 

The “neutral” crowd grew by one-third, which by any measure among the dour aisles of long-term care can be confidently logged as a victory.

Among the widespread optimism is the expectation that census levels will return to, or at least be very near to, pre-pandemic levels by the end of 2023. American Health Care Association President and CEO Mark Parkinson asserted as much in a forecast issued Thursday, adding that an undeniable demographic bubble will keep the momentum rolling through 2024.

Occupancy: The Other O

Coincidentally, the National Investment Center for Seniors Housing & Care on Thursday reported an uptick of 0.7% in nursing care occupancy over the last quarter. That raised the level, according to NIC, to 80.0%, up 6 percentage points from the pandemic low in the first quarter of 2021, but still more than 6 percentage points below the pre-pandemic level of 86.6%.

The McKnight’s Outlook survey buttressed the optimism in skilled nursing growth, with most respondents predicting census would return to pre-pandemic levels by the end of this year. 

To be sure, inflation and regulatory pressures are going to continue to rock the sector. Many operators will have less cash on hand in 2023 and a significant wave of mergers and acquisitions could be forthcoming, especially as federal pandemic relief funding drifts away.

But perhaps the most refreshing indicator that sometimes you just have to give up and admit things might be getting better are these next findings of the McKnight’s 2023 Outlook survey.

Administrators and top executives’ confidence has risen 30% over the 2022 Outlook survey. When asked to rank their job contentment on a scale of 1 to 10, they averaged a 7.3, up from 5.6 a year earlier. Nurse leaders were buoyed even more, rising from an average of 5.5 to 7.3.

Hard times certainly will not be foreign to long-term care in 2023. But optimism — like Honest Abe’s feelings on happiness — is going to be available for those who go looking for it.

James M. Berklan is McKnight’s Executive Editor.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.