As the Covid-19 public health emergency ends, many older adults who need a post-hospital stay in a skilled nursing facility (SNF) will be in for an unpleasant surprise: Traditional Medicare may not pay. The change, one among dozens that affect older adults, restores rules from before the pandemic. But they are complicated and will shock many patients and their families, [...]
The covid-19 pandemic drove a collapse in both patient volume and revenue for post-acute care in skilled nursing facilities (SNFs). And while patient numbers have increased modestly since the worst of the pandemic, they remain far below 2019 and probably are financially unsustainable for the SNFs. At the same time, bipartisan federal legislation in the House and Senate would create [...]
Changes in technology, new government payment models, managed care, and consumer preferences all are shifting services for frail older adults and younger people with disabilities from facilities to home. These models will create new options for consumers and threaten to disrupt the business models of hospitals, traditional nursing homes, and other long-term care facilities. These care models come with a [...]
Someday, most of us will return to life before COVID-19. Nursing homes will not. The deaths of more than 16,000 of their residents from COVID-19 has profoundly disrupted senior living facilities--especially nursing homes-- and will drive historic change in the industry. Robert Kramer, president of the consulting firm Nexus Insights and a long-time observer of nursing home finances, told me, [...]
Last week, I suggested that in the wake of the coronavirus pandemic, nursing homes may need to take patients from over-burdened hospitals. At the same time, care settings such as assisted living facilities (ALFs) might have to accept nursing home residents who must be relocated to make room for those post-acute patients. Now, it looks like that is beginning to [...]
The coronavirus pandemic is stressing hospital capacity to its limits, and one way to reduce this pressure it to move patient care downstream. That means keeping as many patients as possible out of the hospital in the first place, and getting those who have been hospitalized discharged as quickly as possible to make room for other, more critical patients. The [...]
As the coronavirus spreads, many nursing homes and assisted living facilities are discouraging family members from visiting loved ones, and they are screening those who do come. President Trump created additional confusion last night when he urged facilities to “suspend all non-essential visits.” What should you do? There is good reason for concern. While there is no evidence that older [...]
The other day, someone asked me whether, given the coronavirus outbreak, her 93-year-old aunt should go a skilled nursing facility for rehab following a week-long hospital stay. Her question is an important one: What should you do if you or a family member are living in a nursing home or assisted living facility (ALF), or may need to go to [...]
Faced with growing pressures from payors, rising costs, the need to replace old buildings, increased competition from other forms of residential care, and shrinking demand from older adults who prefer to age at home, nursing homes are shutting their doors at a rapid pace. There still are more than 15,000 nursing facilities in the US—more, in fact, than McDonald’s franchises. [...]
Patient advocates really, really want to believe that people discharged from a hospital are better off getting additional medical care and rehab at home than in a skilled nursing facility (SNF). But an important new study of 17 million Medicare claims over seven years tells a more ambiguous story. The study found that post-acute care at home resulted in significantly [...]