John O'Connor

It’s not exactly news that many skilled care operators are now struggling.

The rehab-switcheroo windfall has apparently played itself out at many properties. Meanwhile, occupancy levels generally remain stagnant or worse, despite unchanged supply.

Two new reports further reveal the hazardous driving conditions. First, there was an update from Irving Levin Associates indicating that on a per-bed basis, the average price paid for skilled care facilities dropped by 18% last year. Ouch!

That came out just before Avalere released its own stink bomb. According to its deep thinkers, Medicare beneficiaries have been dialing back their days in skilled nursing facilities since 2009.

Sam Zell once said that real estate is a good business to get into, and get out of. I won’t go as far as to suggest the latter part of that advice currently applies to long-term care, but others might.

Clearly, the field faces some real challenges. But operators who can make some adjustments and ride out this storm might not just survive, but thrive.

Last things first: A major demographic shift could start to benefit the field as soon as 2020, notes a new report from Plante Moran. That’s when the so-called Silver Tsunami (the coming age wave of seniors requiring assistance and post-acute care), will finally begin to reach our shores. Stick around a few years, and you’ll enjoy a huge uptick in demand for the kinds of services your organization provides.

The firm’s first-ever “Make the mark” report also calls on operators to adopt more of a short-stay mindset. That means adjusting your staffing and caregiving efforts to serve customers who may only be at your facility for a few days, rather than weeks or months.

The report’s final recommendation is to adopt more of a hospital-partner mindset. That means more than buttering up hospital discharge planners with sugary treats and assorted tchotchkes.

It means finding a caregiving niche where your performance is superior and/or less costly, and being able to back up your claims with hard data.

For if there is one thing hospitals don’t want to see, it’s the same patient quickly returning with side effects. You have to be the helpful assistant who makes sure bounce backs are not severe enough to trigger Medicare penalties.

Or you could just keep doing the same thing, and hope the marketplace goes back to the way it once was. If that’s your game plan, let me give you some advice that will save you headaches and lost revenue: Sell now.

John O’Connor is McKnight’s Editorial Director.