Trends In the Field
Several trends are dramatically impacting long term care administrators.
Skilled Nursing Trend: PPS
The prospective payment system, instituted by Medicare in the late 1990's, reimbursed nursing facilities at lower rates than previously. This contributed in large measure to several of the largest national nursing homes declaring Chapter 11 bankruptcy in the early 2000s. In recent years the industry has recovered, although the profit margins remain under continuous pressure due to Medicare and Medicaid efforts to trim spending on institutional care and shift monies toward in home and community based care.
The most important trend in 2006-2007 is for reimbursement by Medicare (and in some states by Medicaid) to be based on a computer based calculation of intensity of care use based on the Minimum Data Set. Thus, the MDS coordinator is becoming one of the key positions in the facility inasmuch as both surveys and reimbursement are increasingly driven by the MDS.
Assisted Living Trend: Overbuilding in the Assisted Living Industry
A number of geographical markets in the UNITED STATES are experiencing overbuilding of assisted living facilities resulting in slower fill-up times and a smaller income stream than expected. By 2005 most of the overbuilding had been absorbed and assisted living facilities are enjoying higher occupancy rates today.
Licensure Trend: Licensure of Assisted Living Administrators
Currently only Arizona, Idaho, Nevada, New Jersey and South Carolina require that assisted living facility administrators be individually licensed. However, a number of states are now moving toward this licensure.