The Ensign Group Inc. Case Study: Nursing Home Chains Analysis

In the midst of the Covid-19 pandemic, nursing homes across the United States faced daunting challenges. One such example is The Ensign Group Inc., the second largest for-profit chain in the country. A descriptive case study delves into the financial and quality metrics of this publicly traded U.S. nursing home chain during the age of … Read more

Private Equity Investment in Nursing Home Sector Generates Regulatory Scrutiny

Private equity investment in the nursing home and assisted living sector (other post-acute as well) continues to be a focus of regulatory activity in Congress.  This is despite private equity investment in the nursing home sector to be involve about 5% of facilities. Home health has seen an increasing investment interest as well from private … Read more

Senior Living Rate Increases are Slowing: Revenue Diversification Offers Opportunities

As inflation has cooled, senior living rate increases are slowing. Growing occupancy has been a function of incentives, particularly rate concessions and discounts.  The greatest use of discounting is in independent living, particularly Life Plan organizations/CCRCs. And, while rate increases shift lower, revenue does as well.  Unfortunately, operating cost increases are not subsiding, especially with … Read more

Sr. Living Capital Access Still Challenged

Last week, a report from NIC (National Investment Conference) dropped covering the fourth quarter (2023) lending activity in senior living. As in prior quarters, capital access remains challenged. Data for the report came from 17 lenders, including banks, commercial real estate services, financial services companies, government sources, investment management firms, and real estate investment trusts. … Read more

Maryland SNF Class Action Suit: Nursing Home Residents Seek Mandatory Inspections

Happy Hump Day! Reg’s Blog is back up and running! Lots of stuff has happened over the past couple of weeks that the site was under construction or should I say, remodeling. I’ll try to get caught up on the important stuff and ultimately, get current as new events, etc. happen. Yesterday, an interesting lawsuit dropped … Read more

FTC Bans Employment Non-Compete Provisions – Healthcare Implications Aplenty

On Tuesday, the Federal Trade Commission issued a final rule effectively, banning non-compete agreements, provisions, etc. for employees, including executives. The final rule contains separate provisions defining unfair methods of competition for the two subcategories of workers. Specifically, the final rule provides that, with respect to a worker other than a senior executive, it is … Read more

Regulation Monday: SNF Staffing Mandate and Medicaid Access Rule

Just announced this morning, CMS has finalized two hotly debated proposed rules into final rules. The final rules involve the SNF staffing mandate proposed last year and the Medicaid Access Rule, requiring 80% of payments for Medicaid HCBS programs go to compensation for direct care workers. The Medicaid Rule follows the original proposed rule while … Read more

Friday Feature: Back to the Future and Care Rounds

TGIF! A frequent reader sent me a note earlier in the week and asked if I would drop in more clinically oriented stuff from time to time. I asked for details, and she said stuff “that is germane to patient care and operational improvements – QA/QI stuff”. So, today’s post is by request, sort of. … Read more

Challenges Persist in Staffing for U.S. Life Plan Communities and Skilled Nursing Facilities

Monday, Fitch Ratings dropped a Non-Rating Commentary about staffing challenges in Life Plan and SNF organizations. Per the release, “Though growing for some time, payrolls for U.S. life plan communities (LPCs) and skilled nursing facilities (SNFs) are still well off the pace needed to reach a full post-pandemic recovery.” Bureau of Labor Statistics (BLS) data … Read more

Wednesday Feature: Budget Stuff…Cubed

Happy Hump Day! Busy day so far but wanted to sneak this post in, wrapping up the last two days of posts on budget (federal, Medicare) stuff. This being the third day and post on budgets (and last for a while, I promise), the title fits – cubed. https://rhislop3.com/2024/04/15/monday-budget-day/ https://rhislop3.com/2024/04/16/medpac-report-to-congress-a-wrap-with-monday/ What follows is a different … Read more