There have been so many changes since 2019 and skilled nursing facilities are continuing to Pivot to meet the needs of the aging population.
I continue to read in the news how nursing homes are either closing or changing owners and wonder what the affect will be for the aging population. I am curious with how Healthcare is going to Pivot once again as we move out of the Covid Era and hopefully into more normalcy.
My interest is of course two-fold.
- I work in this industry trying to do my best to advocate and provide care that meets the needs of the elders in my charge.
- I was born in the last year that qualifies me as a baby boomer.
The report actually reviews percentages that are informative for the years 2019-2021.
To see all the statistical reports please use the link provided above
Included in the report are the breakdown of number of skilled facilities for each region/state as well as reimbursement per payor source Medicare, Medicaid, and private Medicare advantage.
InterestIngly is the report re: baby boomers,
Per report; “baby boomers continue to age and move into this age group, we will continue to see this percentage rise annually. In 2020, it was estimated that 16.6% of the population was 65 and over, and according to the U.S. Census Bureau, that grew to 16.9% or approximately 56 million adults in 2021. It is predicted to reach 73 million by 2030. To put this in other terms, in 2021, nearly one in six Americans were over the age of 65.”
Per report:
“In 2022, there are 124 fewer nursing homes in the United States compared to 2021. We had seen this downward trend prior to COVID-19, and the decline continued during the pandemic. In 2022, 33 states have fewer nursing homes than in 2021. The state with the largest decline was Massachusetts, with 11 fewer facilities in 2022.”
Reimbursement has also changed:
Per report, “There has been a steady increase in the percentage of Medicare beneficiaries who enroll in Medicare Advantage plans (the private plan alternative to traditional Medicare) each year, per a recent KFF (Kaiser Family Foundation) report. It is estimated that in 2022, 48% of Medicare beneficiaries
are enrolled in Medicare Advantage plans, compared to 27%, ten years prior in 2012. Alaska has the lowest share of beneficiaries in Medicare Advantage plans with only 1%, while Hawaii has the highest percentage at 59%. Twenty-
five states have at least 50% of their Medicare beneficiaries enrolled in Medicare Advantage plans.”
What does this mean for the nursing home community?
The report points out what most of Nursing Leaders in Skilled facilities know to be true.
• “Facility staff must learn and understand
the billing processes for each Medicare Advantage provider in their region, versus the single process for traditional Medicare.”
• “Medicare Advantage plans often approve shorter lengths of stays in a skilled nursing facility than traditional Medicare would have allowed, resulting in reduced revenue.”
• “Additional paperwork required by facilities for filing appeals and reconsiderations, due to the above point regarding Medicare Advantage plans’ shortened stays.”
• “Skilled nursing facilities are at risk of being “provider liable” if they do not properly obtain prior authorizations and reauthorizations throughout the stay.”
That being noted, I leave you with these thoughts…….
Nursing Home administrators, you have been given the privilege to work with your teams to develop plans that will help your elders get the care they need.
The report helps you identify what is occurring in the industry. Use it to see where you may fall.
Look at what is important for your staff to stay and want to move the needle with you.
What are you doing to retain your staff who know your residents and who your residents feel safe and at home with?
Is your facility’s compensation program in line with industry standards for the staff already employed? Ensuring new hires do not get compensated more than employees who are already on staff and have been dedicated to your residents.
Does your facility model self- care of staff to decrease the risk of staff burnout?
What are you doing to educated your staff re: the difference between Medicare and Medicare private plans to ensure they advocate for longer length of stays if appropriate prior to private company issues the cut letter?
If you would like help in meeting any of these challenges please use the link below
The information presented is informative and does not constitute direct legal or regulatory advice
September 2024\Skilled Nursing Support\maria.messina@skillednursingsupport.com
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