Literature Review

Occupancy on way to 10th consecutive quarter of growthMcKnight’s Senior LivingDecember 14, 2023Senior living occupancy is on its way to 10 consecutive quarters of positive growth, according to NIC MAP Vision’s November intra-quarterly snapshot report. The positive growth trend in senior living—independent living and assisted living combined—marks the longest period of uninterrupted gains since the National Investment Center for Seniors Housing & Care and NIC MAP Vision began reporting data in 2005, Omar Zahraoui, principal at NIC, wrote in a blog. 

Nursing Home and CCRC Spending Grew 5.6% to $191.3B in 2022—After Dropping 7.8% in 2021Skilled Nursing NewsDecember 13, 2023Nursing homes and continuing care retirement communities made up $191.3 billion of national health expenditures in 2022, an increase from $181.1 billion in 2021, reaching levels close to the onset of the Covid-19 pandemic. Pre-pandemic, such expenditures sat between $162 billion and $174.1 billion between 2016 and 2019, according to a survey published by Health Affairs. 

Contessa’s Lessons Learned on Risk-Based Palliative CarePalliative Care NewsDecember 13, 2023As Contessa Health pioneers a growing value-based palliative care-at-home program, they’ve encountered some learning curves when it comes to operating within a new payment system. Contessa is a subsidiary of Amedisys, which the home health and hospice provider acquired in 2021 for $250 million. 

Repositioning Nursing Homes For Acuity, More Closures, Less Deal Making Expected in 2024Skilled Nursing NewsDecember 12, 2023As the skilled nursing industry heads toward a new year with continued labor shortages and reimbursement gaps, service repositioning and closures among operators are expected trends for the space. And although there are signs of positivity in the form of increased Medicaid reimbursement in some states, extensive rural closures are creating “nursing home deserts” and up to 450,000 nursing home residents are still at risk of displacement without a sufficient workforce.  

Long-term care deal volume down as 2024 approachesMcKnight’s Senior LivingDecember 13, 2023As long-term care operators prepare for 2024, the volume of senior living and care deals is down, Paul Branin, vice president of business development at management and consulting firm Health Dimensions Group, said Tuesday. He was one of the experts who during a webinar shared predictions of trends that will shape aging services providers in the coming year. 

Fix needed now—America’s long-term care financing system is brokenBy Katie Smith SloanThe HillDecember 11, 2023Nonprofit providers of aging services have been warning for decades that America’s system for financing long-term care is dangerously broken. The dedicated professionals serving older adults in nursing homes, home health agencies, hospice programs, and senior living communities have toiled side-by-side with families across the country to cobble together care and services for parents, friends, and neighbors—connecting the tattered pieces of our patchwork long-term care system in an effort to ensure dignity, comfort and independence as the needs of our loved ones change. The New York Times KFF Health News’ series “Dying Broke” aptly illustrates the impact of the United States’ insufficient approach to financing of long-term services and supports. It’s an important and unflinching look at how our country is failing us. ... We can do better. A comprehensive and equitable long-term care financing system would make all the difference. The longer lives that many Americans will enjoy offers enormous potential for our nation. We must seize this opportunity and ensure that potential isn’t squelched by an oppressive and unfair long-term care financing system. The solutions are complicated—but smart approaches abound. The variable is political will. ... I urge our leaders to listen to the voices of their constituents, and join us in creating solutions. All of our futures depend on it.

Maine nursing homes lead in meeting proposed staffing standardsMaine MonitorDecember 10, 2023Maine nursing homes are closer to meeting the Biden administration’s proposed minimum staffing standards than their counterparts in most other states, but recent payroll data show that still fewer than one in 10 are meeting these proposed standards every day. And while some long-term care advocates said the national standards should go further, nursing home industry leaders said it would be difficult for a rural state like Maine to find the workers to meet the required minimums, which could lead to more closures. ... During the second quarter of 2023—from April to June—Maine nursing homes met the proposed minimum care hours from both registered nurses and nurse aides an average of 59 out of 91 days in the quarter, according to analysis from The Maine Monitor, USA TODAY and Big Local News at Stanford University, the latest federal staffing data. ... However, only 8% of Maine nursing homes met both standards on all 91 days of the quarter.

State—Nursing home dumped alleged rape victim at homeless shelterIowa Capital DispatchDecember 8, 2023An Iowa nursing home resident was evicted and dumped at a homeless shelter after complaining that an employee of the home raped her, according to state records. ... John Hale, a consultant and advocate for Iowa seniors, said “the story of what allegedly happened to this resident is absolutely sickening. It’s simply incredible that a nursing home and its parent corporation would allegedly have such an awful response to a rape allegation, allow an alleged rapist to continue to be employed, deal so inhumanely with a resident, and would suspend a facility employee who tried to do the right thing.” Hale also questioned the state’s response to the situation. “How the governor or any state legislator can sleep at night knowing that this kind of alleged cruelty exists in an Iowa nursing home is beyond me,” he said. “If this doesn’t serve as a wake-up call to take action, nothing will.”

MedPAC Advises Cutting Skilled Nursing Medicare Payment Rate by 3%Skilled Nursing NewsDecember 8, 2023The Medicare Payment Advisory Commission is recommending that for fiscal year 2025, Congress should reduce the 2024 Medicare-based payment rates for skilled nursing facilities by 3%, citing strong margin projections, occupancy growth and access to capital for the sector.

Funding for nursing homes up 25% after state increaseSouth Dakota SearchlightDecember 7, 2023State funding for nursing homes is up an average of 25% statewide since the Legislature and Gov. Kristi Noem approved more money for them last winter. ... During the last legislative session, Noem and legislators approved 100% reimbursements for those [Medicaid] costs. The move, which went into effect in July, was a reaction to 15 nursing homes closing across the state in recent years, in part due to insufficient reimbursement rates. ... The higher reimbursement rate infused roughly an extra $49 million into nursing homes in the state.

Here’s why you can’t die peacefully in Oklahoma.By Abby RemmingThe OklahomanDecember 6, 2023... Having Medicare or a Medicare Advantage plan would cover hospice, but many people have private insurance from work or state Medicaid plans. Private insurance and Medicaid Advantage plans at times can have a hospice benefit but limit which companies can be used. Applying for Medicare will ensure you are covered for hospice. ... I currently work as a hospital social worker and assist many people who need hospice. Many times, I have had to share with patients and their families that, while they may be ready to peacefully pass away, hospice coverage is not included in the patient’s current insurance plan. Providing end-of-life care is extremely difficult without the added burden of worrying whether insurance will cover the benefit. Those without the benefit and who need the service are then reliant upon the generosity of the companies to absorb the cost. If the Medicaid Advantage plan is picked, a person would need to decide if they wanted the benefit to either cover nursing home care or in-home hospice care. A Medicaid Advantage plan might not cover hospice even when the policyholder believes they have the benefit. 

Bipartisan Legislation Aims to Block CMS Staffing Proposal—Most Recently With Senate BillSkilled Nursing NewsDecember 6, 2023Legislation to block the nursing home minimum staffing proposal gained major traction this week, as a bill introduced on the Senate floor late Tuesday received more bipartisan support. Sen. Deb Fischer (R-Neb.) led the way with the Protecting Rural Seniors’ Access to Care Act, which aims to stop the Centers for Medicare & Medicaid Services from finalizing the minimum staffing proposal—along with requiring that a nursing home workforce advisory panel be created. The Senate bill is endorsed by more than 90 organizations, according to Fischer’s office. 

More people with dementia opting to age in place over senior livingMcKnight’s Senior LivingDecember 7, 2023People living with dementia are more likely to choose aging in place over an assisted living or a continuing care retirement community, according to a new study. A research letter in the Journal of the American Geriatrics Society reported that over the last two decades, a variety of factors have shifted where people with dementia live, including family caregiver availability, declining marriage and birth rates, alternative residential care arrangements, Medicaid expansion of home- and community-based services and the long-term care workforce crisis. Researchers said their study showed that the COVID-19 pandemic noticeably altered living arrangements for individuals living with dementia, increasing the number of those opting to age in place. ... What concerned researchers was increasing functional impairment and levels of unmet needs among those living alone or in a residential care setting, including assisted living and CCRCs, “given the limited regulatory oversight and lack of uniformity in services available in these settings.”