A new week and lots of data/info. coming on a variety of fronts. Today’s post is less about one thing and more about a few things, a bit of smorgasbord to start the week.
- State by State SNF Data/CLA: Back at the start of the month, I wrote a post on the state of the SNF industry, incorporating CLA’s (Clifton Larsen Allen) annual SNF cost report analysis data. That post is here: https://rhislop3.com/2023/10/05/snf-industry-update/ A nifty side piece from CLA is a breakdown of the data by state. By accessing a particular state, one can analyze cost report data including occupancy statistics, payor mix, contract labor use, margins, staffing data (hours per resident day, etc.), and other key metrics. It’s a pretty cool site and easy to use. You can access the site here: https://www.claconnect.com/en/resources/tools/2023/state-by-state-financial-and-operational-metrics?utm_campaign=SNF%20Cost%20Comparison%20Report&utm_medium=email&_hsmi=279882709&_hsenc=p2ANqtz-8zQ2qW1-i7J6EebpJxXHDw0wfmfvjxOkWb09VtVw-bU748d9FZE3QwVM7UXTIKrAwiRk1rRw9br-xj1SEYpdzXlJnqsA&utm_content=279882709&utm_source=hs_email
- Another COVID Litigation Case to Note: In a case involving a Veteran’s home in Massachusetts, the First Circuit Court of Appeals (federal) found the management of the home (primarily clinical leadership) had qualified immunity and thus, could not be sued for their actions/ inactions at the early phases of COVID which may/may not have caused people to become infected. The case involved a CNA that alleged that nursing leadership, medical director, infection control management, etc., ignored risks and proper procedure causing enhanced risks and ultimately, a COVID outbreak that produced deaths.
In its notes on the case, the court explained that under the doctrine of qualified immunity, government officials are immune from liability “so long as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.” Only actors that knowingly violate the law or are “plainly incompetent” can be found liable, the court stated, citing previous case law.
- Housing, Care, and Affordability: Readers of this site over the years know that I have written often about the need for senior housing providers to continue to build care options for their residents, if they wish to survive and thrive. A story in McKnight’s Senior Living brought the subject back to light for me. The story is here: https://www.mcknightsseniorliving.com/home/news/integrating-housing-and-healthcare-to-stimulate-move-ins-and-margins/
For CCRCs/Life Plan communities, the real estate often took center stage yet, residents were as interested in care options as they foresaw, their future years likely requiring access to health care services. Frankly, great care begets move-ins as much as nicely appointed units. The challenge providers face however, is keeping projects affordable. 88% of seniors wish to remain in their home, even when care needs mount. Likewise, a majority of former middle-income seniors cannot afford Assisted Living.
The trick is not to replicate services but to find ways for non-CCRC organizations or for CCRC organizations as well, to build-out the largest variety of service options, focused on everything from wellness/disease management to home care and personal care supports in the home. The largest challenge, however, is to maintain affordability. The way to accomplish this is to develop strategic alliances and partners. Medicare Advantage is one such partnership that in most cases, is a good place to start (especially in locations with heavy Medicare Advantage participation rates). A recent article I did on Medicare Advantage plans and their growth is here: https://rhislop3.com/2023/10/17/medicare-advantage-status-update/
- House Budget Committee Health Care Task Force: The House of Representatives Budget Committee formed a task force to seek recommendations and ideas on ways to improve health care access, quality, and efficiency. To help inform the Health Care Task Force’s work, Task Force members issued a request for information (RFI) to solicit feedback from independent experts and stakeholders on solutions to improve outcomes and reduce federal health care spending in the budget. Responses were due by October 15. The link to the Task Force news release is here: https://budget.house.gov/press-release/chairman-arrington-rep-burgess-launch-budget-committee-health-care-task-force
The fastest growing spend in health care is related to Medicare, senior health related issues, and chronic illness. Post-acute provider segments such as home health and skilled nursing have seen explosive growth in Medicare and Medicaid spending across the past two decades.
Medicare Advantage is also a rapidly expanding program and a recent report MedPAC indicates that the federal government is actually spending more (6%) for Medicare Advantage participants than for traditional Medicare Fee for Service participants. I’ll look at this a bit more in-depth in a future post. For now, the submission/comments to the task force from LeadingAge (senior living and health care trade association) is a great read. It is available here: LeadingAge-Comments-on-House-Budget-HC-Task-Force-_231026_110225