Seventy percent of skilled nursing chief financial officers are optimistic about their organizations’ ability to compete in their local post-acute care marketplaces, according to new insights from investment firm Ziegler.

The numbers are slightly down from last year, when about 78% of CFOs said they were optimistic about their competitiveness in the post-acute care space. This year, about 26% said they were unsure about their organization’s competitiveness, while about 4% said they weren’t optimistic. Compared to 12.9% and 8.3%, respectively, last year.

Ziegler’s insights are from an August survey of 183 CFOs and finance professionals and focused on changes in occupancy, future plans for skilled nursing units, the impact of Medicare Advantage plans and facilities’ ability to compete. 

A majority of providers are being hurt by Medicare Advantage plans, according to the survey. About 70% of all providers reported a moderate to significant negative impact, while just 6% reported a moderate to significant positive impact. About 24% said they felt little impact. 

“Medicare Advantage Plans in rural settings are more challenging because insurance companies will not always just allow new providers to enter the in network system. Hospital-based SNFs and systems have an advantage over single site providers based on volume. [We] need the advantage plans to look more closely at outcomes from all the providers when it comes to admission to their network,” one CFO noted in the survey. 

“Any Medicare Advantage billings that we have had have been terrible. The insurance company pre-authorizes the care; pays for it and then 6 months to a year later takes the money back,” another CFO stated. 

Thirty-two percent of providers reported that long-term skilled nursing occupancy was lower than last year, while 47% said their occupancy remained the same. About 22% said occupancy was higher. 

On the short-stay side, about 39% said their occupancy was lower than a year ago, while 38% said it remained the same. About 23% of providers reported higher occupancy when compared to 2018. 

Findings also showed that 80% of providers are noticing shorter lengths of stays in skilled nursing. Additionally, 83% reported they’re seeing patients with more acute needs. 

About 55% said they’re seeing more treatment plans skip skilled care altogether, while 49% said they’re experiencing a narrowing of networks from area hospitals and physician groups.