John O'Connor

You are unlikely to meet many people who understand this field quite like Robert G. Kramer.

The man who helped found the National Investment Center for Senior Housing & Care more than a quarter century ago is a human cornucopia of insight and wisdom.

So when he talks about what skilled care operators should be doing to get past the turbulent years to come, it’s probably a good idea to listen up. Such was the case Thursday, when he spoke in Dallas during a PharMerica educational symposium.

It’s no secret that operators will be under unprecedented pressure to deliver better care at lower costs. As Bob describes it, this changing landscape will force many a skilled care operator to make data investments that have a multi-year gestation period. For that we can thank managed care and accountable care organizations that will increasingly be tempted to send post-acute patients straight home to supposedly save money.

It’s probably not going to be until the tactic results in higher hospital readmissions and Medicare payment penalties that this “cost saving” move gets abandoned, he suggested.

But once hospitals start getting penalized – and skilled care facilities can prove with data that they do a better job of preventing avoidable readmissions – the pipeline to SNFs is likely to reopen.

That means operators will really need two strategies going forward, he insists. For the short term, the emphasis will need to be on survival. As for those who do manage to stay in business, a post-drought strategy focused on growing the business will also be essential.

It’s a compelling argument. But are we 100% guaranteed that things will play out this way? On the other hand, is any prediction about the future 100% guaranteed?

What I do know is this: There may not  be another person on the planet who has studied this market as closely or for as long as Kramer. Ignore his advice at your own peril.