Healthcare, Senior Living, Economics
Last year 2017, was a bit of a “downer” in terms of mergers/acquisitions in the home health and hospice industry. Though 2017 was fluid for hospital and health system activity, the home health and hospice sectors lagged a bit. Some of the lag was due to capacity concerns in so much that health system mergers, if … Read more
A number of years ago, post-acute/senior living analysts, etc. started warning of a coming paradigm shift for skilled nursing and home health. I started writing and advising about this shift well over a decade ago. The signs were obvious. Rapid expenditure growth as a percentage of Medicare/Medicaid outlays. MedPac warnings to Congress of rising profit margins in … Read more
What do Morningside Ministries in San Antonio, Genesis Healthcare, Signature Healthcare, HCR ManorCare, and Syverson Health and Rehab in Wisconsin have in common? Answer: A terminal relationship with Medicaid. While Genesis isn’t “dead” yet, it is fundamentally on life support with a stock price of $1.50 per share and a Medicaid payer mix averaging 73%. HCR ManorCare is … Read more
As 2017 closed, a number of projects kept me busy right up to the Christmas holiday. Among these projects was a focus on the SNF industry current and its fortunes going forward, principally driven by clients in the investment industry. With REIT troubles, portfolio defaults on the part of HCR and Consulate, Sabra divesting Genesis facilities … Read more
A few weeks back, I wrote a piece regarding Medicaid and its ties to the fortunes (lack thereof ) of some the largest SNF provider groups. Today a high percentage of resident census connected to Medicaid as a payer source is the largest contributor to the flagging financial condition of Genesis, HCR/ManorCare, Signature, and others. With … Read more
There is an old joke/riddle that goes like this: “Where does an 800 lb. gorilla sit? Answer: Anywhere it wants to”. For SNFs and REITs today, that gorilla is Medicaid. Sure, there are numerous industry headwinds that SNFs face in terms of financial performance; Rising percentage of Medicare Advantage patients as part of the payer … Read more
Lately I’ve written rather extensively on what is occurring in the SNF sector to (rather) dramatically shift the fortunes for companies such as HCR/ManorCare, Kindred, Genesis, Signature, et.al. and a series of REITs that hold SNF assets (physical). In addition to my writings, I’ve consulted/conversed with numerous investment firms concerned and interested in this shift. Underlying all of my … Read more
Long title – actually shortened. In honesty, I clipped it back from: SNF Fortunes, HCR/Manor Care, Five Star, Value-Based Payment, Hospitals Impacted Too, Home Health and Hospice Fortunes Rise, and all Other Salient Lessons for/in Health Care Today. Suffice to say, lots going on but almost all in the category of “should have seen it … Read more
As the title of this post implies, a review of the status of the SNF industry is as much about current issues begat by past issues influenced by an outlook that is finally, starting to congeal. Writing that (sentence) was convoluted enough and that is exactly, where the bulk of the industry issues are. To begin, … Read more
Early into the Trump presidency and health care/health policy is front and center. The first “Obamacare repeal and replace” attempt crashed and burned. The upcoming roll-out of the next round of bundled payments (cardiac and femur fracture) is delayed to October from the end-of-March target date. Logically, one can question is a landscape shift forming? Doubtful. … Read more