Skilled Nursing Facilities (SNF)

It's news -- 600 nursing homes closed so what’s the strategy to fix? Rant on.  You may have read a depressing article this morning in the Wall Street Journal about the number of people stuck in hospitals with no place to go because there are no nursing homes to take them – which is the status in the UK’s National Health System (NHS).  That was an embarrassment in the UK – and this is a scandal in the US. It never should not have gotten to this point. So many factors crushed nursing homes -- Covid and Private Equity nursing home ownership were big players, followed by government strategy to undermine them. For 14 years, Florida banned new nursing home construction. The federal “Money Follows the Person” was introduced in 2005 to enable seniors to avoid them and receive Medicaid-paid services. Reauthorized repeatedly, it is now authorized through 2027. 

What care delivery has seen an uptake in technology adoption? People imagined that post-Covid-19, technology would become much more compelling in all types of care delivery. And for sure, the pandemic institutionalized the role of in-home telehealth, with CMS reimbursement presumed to become permanent, or at least regularly renewed. In fact, 23% of respondents to a government survey had used telehealth during a 6-month period in 2021. Also for sure, the use of healthcare portals has seen increased penetration – in 2020, 60% of patients in the US were offered access to a portal, and 40% accessed their records through it.   

 A well-known consulting firm assesses the growing care gap. Boston Consulting Group analyzed the care crisis recently asserts that the lack of paid or unpaid care workers to provide care of children or aging parents may prevent them from filling unfilled jobs, noting the 99 million people today who are not in the workforce. y do an interesting analysis built around the premise that some people who could work do not because of care responsibilities. The conclusion -- the one hand, quality affordable care could be subsidized so that more would want to do the work, filling the unfilled care jobs (day care, elder care). And family members could thus remain in jobs that they would otherwise abandon to provide care. Okay, hard to argue with this macro view, but there are some key points missing. Take a look at Exhibit One in the document which asserts that nearly 50 million people, aged 18-64, could become part of the care labor force, particularly those that have children and remain at home to care for them.