As the COVID carnage may cool down, expect the heat from nursing homes to increase


They say you can put a live frog in a pot of water and slowly boil it into a great snack and never know the master plan.

The key is to raise the temperature a degree or two at a time, and Kermit will never know what brought him in.

I have never performed this cooking experiment, but I know there are many ways dangers can creep up on someone if they are unaware or unsuspecting. Whether it’s glaciers, pots of boiling water, or mission creep at work, you can be in big trouble at the door and there’s nothing you can do about it if you’re not careful enough.

Well, it looks like there might be more issues for skilled nursing operators and the nursing home business model. The problem is that this column and other sources can tell you it’s happening, but you still might not be able to reverse it.

In the spirit of “forewarned is forewarned,” let’s take a look.

I’ve heard Harvard professor David Grabowski, a prominent long-term care policy researcher, speak several times. I have often spoken with him and I know his research well. Still, one of his observations on Monday’s LeadingAge COVID-19 conference call was still a bit shocking.

He said the care home business model was going to be “very different” in a year or even six months.

Not particularly known for promoting hyperbole – neither he nor I – that seemed like a pretty bold statement. After all, regulation-strapped long-term care providers are used to being under siege. Just ask anyone in charge of regulatory filings or legal considerations.

But he is right. While the biggest and deadliest dangers of COVID-19 generally move away from the nursing home stage, there are other threats behind the scenes. If you haven’t noticed lately, the sympathy factor for nursing homes, which paid the price with 43% of COVID-19 deaths in the United States at the start of the pandemic, has declined. , or even almost evaporated.

Those waiting for more COVID relief funds shouldn’t hold their breath without oxygen tanks nearby. This will significantly stress weaker financial operations.

Then when the public health emergency designation is allowed to expire, which will surely happen at some point in the near future, regardless of the announcement this week that it will be extended beyond July, the helpful waivers in the event of a pandemic and other supports will disappear. Some, in fact, are already gone, and the Centers for Medicare & Medicaid Services will end another round in about three weeks.

Attracting and retaining staff will continue to be a problem for skilled nurse operators. Additionally, getting short-term residents (i.e. reimbursed by Medicare) in-house will become an even greater threat to the industry.

All these rumors about the growth of home care and home hospital services are not just a figment of anyone’s imagination. These movements prevent the census of nursing care establishments.

So we’re going to continue to see more suppliers in more hot water. Facility closures can maintain appear on the radar more often. It may just look like smaller or “underperforming” installations meeting their fate, but if you look closely day after day, “closing business” signs are selling out at a relatively rapid rate.

Expect more of the same and, as the temperature continues to rise, a “very different” market in the months and year ahead.

James M. Berklan is editor of McKnight’s Long-Term Care News.

Opinions expressed in McKnight’s columns are not necessarily those of McKnight.


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