SENIOR CARE CONUNDRUM: Skilled Nursing Rightsizing Strategies

Skilled Nursing Rightsizing Strategies are the Senior Care Conundrum Nonprofit Life Plan Communities face the conundrum of upholding longstanding missions to provide lifelong care, regardless of residents’ means or abilities, while facing escalating financial pressures on operations. Skilled nursing rightsizing is unique to each senior living provider, but it typically entails downsizing “high care” and managing the payor mix.

Complex Care is Adding to Cost Pressures

As Life Plan Communities implement strategies to help residents stay healthier for longer periods and access to in-home care increases, community sponsors report that skilled nursing care is becoming a much shorter term, but more costly “very end of life” stay for most. Even if committed to maintaining the full care continuum, Life Plan Communities must rightsize their offerings to close the gap between operational costs and insufficient reimbursements.

“As we move away from large brick-and-morter settings, with residential skilled nursing reserved for the most complex cases, providers must manage risk,” shares Kevin Schwab, CEO of Givens Communities in Asheville, NC. “A smaller skilled nursing facility will likely be more costly to operate and this will be compounded if a large number of residents stay there long enough to exhaust their resources.”

As community sponsors are exploring every opportunity to manage costs, a myriad of programming and design strategies have emerged:

    1. Economies of Scale
    2. At-Home Services
    3. Shared Rooms to Private
    4. Specialized Care Households
    5. Assisted Living / Personal Care
    6. Apartments / Concierge Living
    7. Creative Partnerships

It is impossible to know how current and evolving trends will impact skilled nursing in the future.

  • Will more states provide viable reimbursement options for assisted living?
  • Will the Centers for Medicare & Medicaid Services (CMS) moderate its anticipated minimum staffing proposal?
  • Will the aging Boomer wave overwhelm the remaining Long Term Care system as fewer and fewer skilled nursing beds are available?

While we cannot predict specific outcomes, we know that a wave of people will reach the age when they are likely to need skilled nursing care at the precise moment when it may have nearly vanished from the senior living landscape. Now is the time to think how and where this critical care can be cost-effectively delivered.

Download the Skilled Nursing Rightsizing Strategies White Paper:

Solving the current care conundrum is going to look different for each provider with varied models and new approaches. To see how some other providers, of varying sizes and located in different areas of the country, have tackled this challenge, download the Whitepaper via the form below.

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Additional Resources: 

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