John O'Connor, VP, Associate Publisher, Editorial Director

The billionaire investor Warren Buffet famously refused to time the stock market. His rationale: Nobody really knows what the future will bring.

But that keen insight hardly keeps the rest of us from trying to handicap the road ahead.

Take the future of skilled care. These days, it appears both the optimists and naysayers are in ample supply.

Among the prosperity-is-just-around-the-corner crowd, several talking points are now in vogue. Among them: Skilled care’s limited supply makes it less vulnerable to the ugly downside of careless capital; operators are going to make a killing under the new Patient-Driven Payment Model; skilled care has always found a way to survive, if not thrive; and of course, the coming Silver Tsunami — which will harness the power of sheer numbers to help every facility succeed.

Then there are the downers. To say they are not bullish on skilled care is like saying Michael Cohen probably won’t be getting a holiday card from the White House this year.

Why are they so negative? Let me count (some of) the ways: Skilled care’s housing stock is aging and cumbersome; nobody wants to be placed in a skilled care facility; it relies too much on rehab; PDPM may actually reduce payments; and home care, assisted living and other alternatives will continue to degrade skilled care’s market share. And, by the way, good luck keeping any semblance of adequate staff in place.

So it’s probably safe to say that skilled care has its challenges and opportunities to look forward to.

Not that this is exactly what you’d call a new development. The field has always had its backers and skeptics. My guess is that neither group will be leaving the scene any time soon. That tends to be the reality in sectors where unpleasant work is in high demand.

As to whether the market will be better off or worse, in say, 10 years? I really have no idea.

But I do have some advice that could prove to be rather useful: Any time you talk to someone who insists he or she absolutely does know, try to do the following: Nod politely, avoid sudden moves and slowly back away.