John O’Connor

The late author Joseph Heller provided words that many long-term care operators still live by: “Just because you’re paranoid doesn’t mean they aren’t after you.”

Whether most operators are paranoid is a matter of conjecture. But it’s no secret that many feel they have a big ol’ target on their backs.

Maybe that sentiment derives from decades of battles with heavy-handed regulators. Maybe it’s from the thousands and thousands of unflattering media reports. Maybe it’s the exhaustion that comes from not knowing from year to year how federal and state lawmakers might make things more difficult.

Maybe it’s a combination of these and other chafing factors. Regardless, it’s easy to see that this is a sector that does not appear to be feeling very good about itself or the way it gets treated these days.

But don’t take my word for it. Take yours. Or at least, those of 200 colleagues. They participated in a recent Ziegler CFO Hotline poll, and this is what they had to say:

•   Compared to a year ago, 40% said their short-stay post-acute occupancy is down (barely half as many — 23% — indicated such occupancy is rising).

•  More than 8 in 10 (83%) said that resident care needs are rising, and 80% indicated lengths of stay are declining.

•  Moreover, nearly half indicated that networks from area hospitals and physician groups are narrowing.

I can almost see people nodding in agreement as they read this, for it reflects a reality that many will find all too familiar.

But let’s ponder for a moment what this means: Occupancy challenges are not going away. As for the residents that do arrive, they are coming in sicker and need to be moved out faster. Oh, and two of the most reliable sources for new residents are drying up.

There is simply no way to sugarcoat these developments as promising signs.

So the industry is furiously doing anything and everything to offset these challenges, right? Well, not exactly.

The same survey found that when it comes to making changes, more than half of the respondents (60%) don’t plan to make any. Let that sink in for a moment.

Long-term care operators have every right to feel a bit tense and morose about current conditions. And maybe a bit of paranoia is justified. The reality is that there are a lot of people out there who don’t have your back.

But to know conditions are worsening, and to respond by doing nothing? That’s not fixing problems. That’s ignoring them.

John O’Connor is McKnight’s Editorial Director.